3 month old male baby, born by IVF, LSCS at term, B wt - 2.4 kg, normal APGAR ,required phototherapy for exaggerated phy jaundice, with norma thyroid n g6pd, on mixed feeding was brought with fever, cold n cough for 3 days. On examination child was febrile, with stable vitals, pallor present, weighing 4.8kg, P/A- distended with free fluid, liver 4cm from costal margin, no splenomegaly n normal bowel sounds, other system examination is unremarkable. On investigating hemogram showed hb -9.2, tlc- 33000 with P 33 , PLATELETS 1 lac. Mcv 90, RDW19, dimorphic picture with toxic granules n thrombocytopenia, LFT- OT/PT-88/76; TSB- 0.6; total pro / alb - 5.2/ 3.1 normal KFT, urine routine.
Chest x ray - n, USG abd moderate ascites, normal liver echogenicity . Rest of strucures normal. Coagulation profile - n , ascitic fluid analysis- 400 cells with 90% lym, SAAG 1.6, ADA neg, TB PCR report…
